Epidural steroid injections (ESIs) are one of the most commonly performed procedures in pain management. Here is exactly what to expect at every stage.

What Is an Epidural Steroid Injection?

An ESI delivers a corticosteroid directly into the epidural space surrounding your spinal cord and nerve roots. The goal is to reduce inflammation around compressed nerve roots — the source of radiating pain, numbness, and weakness from disc herniations and spinal stenosis.

Before the Procedure

  • Arrange a driver — you cannot drive yourself home
  • Avoid a heavy meal 2–4 hours before your appointment
  • Continue regular medications unless instructed otherwise
  • If you take blood thinners (Coumadin, Xarelto, Eliquis, Plavix), notify our office in advance
  • Wear comfortable, loose-fitting clothing

During the Procedure

The procedure takes 15–30 minutes. You lie face-down on a fluoroscopy table. The skin is numbed, Dr. Qureshi uses live X-ray guidance to position the needle precisely, confirms placement with contrast dye, then delivers the steroid and local anesthetic. Most patients feel pressure rather than sharp pain.

After the Procedure

  • Day 1: Pain may temporarily worsen as local anesthetic wears off
  • Days 2–5: Most patients begin noticing improvement
  • Days 7–14: Full effect is usually reached
  • Avoid strenuous activity and pools for 24–48 hours

How Much Relief Can I Expect?

Studies show 70–80% of patients with disc-related pain respond positively. Relief typically lasts 1–6 months. Up to 3 injections per year are typically covered by insurance. ESIs are most effective when combined with physical therapy during the period of reduced pain.

Frequently Asked Questions

How long does an epidural steroid injection take?
The procedure takes 15 to 30 minutes. You lie face-down on a fluoroscopy table while Dr. Qureshi uses live X-ray guidance to position the needle precisely and deliver the steroid and local anesthetic.
Is an epidural steroid injection painful?
The skin is numbed before the procedure, and most patients feel pressure rather than sharp pain. Pain may temporarily worsen on day one as the local anesthetic wears off, but most patients begin noticing improvement within 2 to 5 days.
How effective are epidural steroid injections?
Studies show 70 to 80 percent of patients with disc-related pain respond positively. Relief typically lasts 1 to 6 months. ESIs are most effective when combined with physical therapy during the period of reduced pain.
How many epidural steroid injections can I have per year?
Up to 3 injections per year are typically covered by insurance. Your doctor will determine the appropriate number based on your response to treatment and individual circumstances.
What should I do to prepare for an epidural steroid injection?
Arrange a driver as you cannot drive yourself home. Avoid a heavy meal 2 to 4 hours before your appointment. Continue regular medications unless instructed otherwise. If you take blood thinners, notify the office in advance. Wear comfortable, loose-fitting clothing.

This article is for educational purposes only and does not constitute medical advice. Schedule a consultation with Dr. Qureshi at (281) 982-2144 for personalized guidance.